CIPD - Mental health at work

Health, safety and well-being

Revised April 2008

This factsheet gives introductory guidance. It:

outlines the social, economic and legal implications of mental ill health within the workplace
sets out guidelines and recommendations for the implementation of a mental health policy
provides guidance on how employers may seek medical advice about an employee's capability.

According to the 2001 World Health Organisation report, one person in four will suffer from a mental health problem at some point in their life¹. And a 2006 report commissioned by five leading mental health charities states that at least one million adults in the UK are out of work with mental health problems².

The legal position

Under the Disability Discrimination Act 1995 (DDA), it is unlawful for an employer to treat a disabled employee, or potential employee, less favourably than others by:

discriminating against a disabled person in employment
failing to provide any reasonable adjustments for the disabled employee or applicant at a serious disadvantage in relation to others.

Changes to the DDA introduced in December 2005 mean that mental illness no longer has to be a clinically well-recognised condition to be covered by the Act. Applicants will only have to prove that the disability has a substantial and long-term effect on their ability to carry out normal day-to-day activities. The changes mean that individuals suffering from stress may be able to claim they should be protected by the DDA.

A person who has recovered from a disability covered by the DDA remains protected. Long-term means that the disability has continued or is expected to continue for at least one year, but recurring or episodic conditions are covered if the substantial adverse conditions have a propensity to recur after the initial episode.

In December 2003, the draft fourth part of the data protection code of practice on employment practices was published dealing with details about a worker's physical or mental health. As information on workers' health is 'sensitive personal data', any health information should be strictly limited to what is necessary to fulfil the purpose identified. Due to the sensitive nature of mental illness, employers should ensure that there is only appropriate access to records regarding the mental health of an employee. For more information, see our factsheet on data protection.

Go to our factsheet on Data protection

Dealing with mental health in the workplace

People with mental health problems are not a uniform or homogenous group. Individuals will face challenges specific to themselves and many may need little or no support at work. However, discrimination against people who declare any mental health problems is still widespread - even though a significant proportion of the workforce will face mental health difficulties during their working life.

Employers who wish to create a healthy work environment will recognise the need to establish policies and procedures in the area of mental health that set out a tangible programme with measurable targets and an effective auditing process. The Health and Safety Executive (HSE) recommend that a mental health policy should be an integral part of any organisation's health and safety at work policy. Such an initiative demonstrates that the organisation recognises and accepts that mental health is an important issue and emphasises the organisation's commitment to promoting the mental health of its workforce.

Developing a mental health policy

Negative, stigmatising attitudes are a serious obstacle to the development and successful implementation of a mental health policy and hence the improved mental health of employees. Consequently the most important step in the process is to bring about a positive change in attitude and assumptions amongst employees and management towards mental health.

An equal opportunities policy that seeks to overcome barriers to the recruitment and retention of people with a mental health problem is an excellent way of mitigating against stigmatisation on the grounds of mental health. An integral feature of the policy should be the need to emphasise to all employees the organisation's commitment to ensuring that people with mental heath problems are included within the scope of equal opportunity and diversity policies.

Information on mental health issues should be included in:

training of supervisory staff on managing disability which should give specific examples of behaviour which may indicate mental health problems
disability awareness training for all levels of staff
job advertisements.

Also, positions where specific adjustments could be made to enable people with a mental health problem to gain and sustain employment should be identified.

Recruitment

Due to fear of discrimination potential employees may choose not to disclose a mental health problem in their application or at the interview stage. It is important for the recruiting company to:

make it known, at the recruitment stage, that it is willing to make reasonable adjustments for disabled applicants and that this policy includes people with a mental health problem.
ensure all employees understand the concept of adjustment within the organisation's equal opportunities policy.

When drawing up the job description and person specification care should be taken to enable adjustments to be made to accommodate people with a mental health problem. Steps should be taken to:

distinguish between essential and desirable requirements for the job and focus on what is to be achieved rather than how.
ensure that the mental or emotional elements are identified specifically the ability to meet set work schedules.

As someone with a mental health problem may not have attended an interview for some time consideration should be given to:

permitting the applicant to be accompanied and/or to have additional time to undertake a test of ability.
appreciating perceived 'deficiencies' due to their mental health problem, such as gaps in their employment history.
providing the appropriate environment to try and ensure the applicant is able to demonstrate fully their ability to do the job.

Creating a healthy workplace

Employers should provide a healthy environment where all employees are supported to develop and utilise their skills and abilities to their full potential.

Work-related stress is the root cause of a significant degree of mental ill health. Stress can manifest itself in absenteeism, reduced productivity, and increased staff turnover. Excessive stress can lead to fatigue, impaired judgement and decision-making and the onset of both mental and physical health problems. For more infromation on this aspect of mental health, see our factsheet on dealing with workplace stress.

Go to our factsheet on Stress at work

Adjustments at work

Should an employee's work performance give rise for concern it is important to determine if the problem is related to disability caused by a mental health problem. In such cases appropriate adjustments based on the individual's circumstances can be made. When an adjustment is required the employee's manager will need to know that this is the case, but neither the manager nor fellow employees need to be told the medical reason behind the decision. Through the equal opportunities policy all employees should understand the benefits to be derived from the use of adjustments.

Returning to work after a long-term absence

The process of rehabilitation after a mental health problem will usually be more cost-effective and beneficial to both parties than early retirement. Therefore employers will need an effective absence management programme with early 'trigger' points, supported by effective communication between occupational health, HR and line managers - for further details see our factsheet on managing and measuring absence.

Go to our factsheet on Absence measurement and
management

To facilitate this process it is important to:

carry out a return-to-work interview to determine if the employee needs any adjustments to be made.
continue the process with follow-up interviews to monitor progress.
ensure effective and on-going communication between the employee, first line manager, and personnel and occupational health departments.

Clinical and professional advice

As with physical disability, there will be occasions when specialist advice is needed to assist someone with a mental health problem.

This may be when:

there are frequent short-term and/or long-term absences from work
the employee appears to be experiencing side-effects from medication
perceived unusual behaviour patterns take place.

There should be a procedure in place to ensure managers are confident as to the action to take place in seeking such advice. Advice should only be sought on specific issues directly related to the person's employment. Decisions affecting the employee should only be based on medical advice as it applies to the specific work environment.

Some assumptions about mental illness may mean that psychotic episodes or perceived dangerous behaviour patterns may be dramatised and exaggerated. In an organisation with an effective mental health policy the risk of inappropriate action by employees or managers will be minimised. Instead, there will be recognition that, as with serious physical illnesses, there are occasions when expert medical assistance is urgently needed to assist the person with a mental health problem.

As employers have a duty to make provision for emergencies that may affect the health and welfare of their employees it is essential to recognise the needs of all disabled employees, irrespective of the disability.

Implementing and auditing the mental health policy

It is crucial to the success of the policy that:

it is developed by a working group with a membership that represents the different work groups
there is commitment to the aims and objectives of the policy by employees and management
regular monitoring of performance against targets is undertaken
the review findings lead to a programme of continuous improvement.

Useful contacts

General

Department of Health

Employers' Forum on Disability

The Mental Health Foundation

Mind (the mental health charity)
MindInfoline: +44 (0) 845 760 0163

Rethink (formerly the National Schizophrenia Fellowship)Advice line: tel: +44 (0)20 8947 6814

Addictions

Alcoholics Anonymous

Gamblers Anonymous

Narcotics Anonymous

Bereavement

The Compassionate Friends

Cruse

Counselling

The Samaritans
Tel: +44 (0) 845 790 9090

Depression

Manic Depression Fellowship : the BiPolar Organisation

Eating problems

Eating Disorders Association

Fears and anxieties

National Phobics Society

References

WORLD HEALTH ORGANIZATION. (2001) Mental health: new understanding, new hope. The world health report 2001. Geneva: WHO. Available at: http://www.who.int/whr/2001/en/
BIRD, A. (2006) We need to talk: the case for psychological therapy on the NHS. London: Mental Health Foundation. Available at: http://www.mentalhealth.org.uk/publications/?EntryId=40848

Mental health at work